<div class="box box-primary" xmlns:th="http://www.thymeleaf.org">
	<div class="box-header with-border">
		<h3 class="box-title">医院信息</h3>
	</div>

	<form id="hospitalForm" class="form-horizontal">
		<input id="type" type="hidden" th:value="${type}"/>
		<input id="hosId" type="hidden" th:value="${hosId}"/>
		<div class="box-body">
			<div class="form-group">
				<label for="hospital_code" class="col-md-2 control-label">医院代码<span
					class="colorred">*</span>：
				</label>
				<div class="col-md-4">
					<input id="hospital_code" class="form-control" type="text"
						name="hospital_code" bindname="hospital_code" btvd-type="required"
						btvd-class='btvdclass' maxlength="50" placeholder="医院代码..." />
				</div>
				<label for="hospital_name" class="col-md-2 control-label">医院名称<span
					class="colorred">*</span>：
				</label>
				<div class="col-md-4">
					<input id="hospital_name" class="form-control" type="text"
						name="hospital_name" bindname="hospital_name" btvd-type="required"
						btvd-class='btvdclass' placeholder="请输入中文名称" maxlength="50" />
				</div>
			</div>
			<div class="form-group">
				<label for="hospital_level" class="col-md-2 control-label">医院级别<span
					class="colorred">*</span>：
				</label>
				<div class="col-md-4">
					<select id="hospital_level" name="hospital_level"
						bindname="hospital_level"></select>
				</div>
				<label for="hospital_rank" class="col-md-2 control-label">医院等级<span
					class="colorred">*</span>：
				</label>
				<div class="col-md-4">
					<select id="hospital_rank" name="hospital_rank"
						bindname="hospital_rank"></select>
				</div>
			</div>
			<div class="form-group">
				<label for="addr" class="col-md-2 control-label">医院地址：</label>
				<div class="col-md-4">
					<input id="addr" class="form-control" type="text" name="addr"
						bindname="addr" maxlength="100" placeholder="医院地址..." />
				</div>
				<label for="domain_name" class="col-md-2 control-label">医院网址：</label>
				<div class="col-md-4">
					<input id="domain_name" class="form-control" type="text"
						name="domain_name" bindname="domain_name" maxlength="100"
						placeholder="医院网址..." />
				</div>
			</div>
			<div class="form-group">
				<label for="owner_province" class="col-md-2 control-label">所属省：</label>
				<div class="col-md-4">
					<select id="owner_province" name="owner_province"
						bindname="owner_province"></select>
				</div>
				<label for="owner_city" class="col-md-2 control-label">所属市：</label>
				<div class="col-md-4">
					<select id="owner_city" name="owner_city"
						bindname="owner_city"></select>
				</div>
			</div>
			<div class="form-group">
				<label for="owner_country" class="col-md-2 control-label">所属区县：</label>
				<div class="col-md-4">
					<select id="owner_country" name="owner_country" bindname="owner_country"></select>
				</div>
				<!--  
				<label for="parent_id" class="col-md-2 control-label">上级医院：</label>
				<div class="col-md-4">
					<select id="parent_id" name="parent_id" bindname="parent_id"></select>
				</div>
				-->
				<label for="telephone" class="col-md-2 control-label">联系电话：</label>
				<div class="col-md-4">
					<input id="telephone" class="form-control" type="text"
						name="telephone" bindname="telephone" maxlength="20"
						placeholder="联系电话..." />
				</div>
			</div>
			<div class="form-group">
				<label for="hospital_profile" class="col-md-2 control-label">医院简介：</label>
				<div class="col-md-10">
					<textarea id="hospital_profile" class="form-control" rows="4"
						name="hospital_profile" bindname="hospital_profile"
						placeholder="医院简介 ..."></textarea>
				</div>
			</div>
		</div>
		<div class="box-footer">
			<button id="cancel" type="button" class="btn btn-default pull-right">取消</button>
			<button id="save" type="button" class="btn btn-info pull-right mr30">保存</button>
		</div>
	</form>
</div>
<script th:if="${projectModel=='dev'}" th:src="@{/static/js/business/sysmanage/hospital/form.js(v=${#dates.createNow().getTime()})}"></script>
<script th:if="${projectModel=='product'}" th:src="@{/static/js/business/sysmanage/hospital/form.js}"></script>